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Sanders R, Edwards L, Nishisaki A. Tracheal Intubations for Critically Ill Children Outside Specialized Centers in the United Kingdom-Patient, Provider, Practice Factors, and Adverse Events. Pediatr Crit Care Med 2019; 20:572-573. [PMID: 31162351 PMCID: PMC6550333 DOI: 10.1097/pcc.0000000000001946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Ron Sanders
- Section of Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, AR Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA
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52
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Cook TM. Response to: Emergency front-of-neck access: scalpel or cannula-and the parable of Buridan's ass. Br J Anaesth 2019; 119:840-841. [PMID: 29121321 DOI: 10.1093/bja/aex314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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53
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Cook TM, Kelly FE, Foy K, Mew E, Bower J, Marden B, Dean S, Knight P, Herneman K. The PIC-NIC survey: capnography and neonatal intensive care - a reply. Anaesthesia 2019; 74:118-120. [PMID: 30511756 DOI: 10.1111/anae.14529] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- T M Cook
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - F E Kelly
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - K Foy
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - E Mew
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - J Bower
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - B Marden
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - S Dean
- Bristol Royal Hospital for Children, Bristol, UK
| | - P Knight
- Bristol Royal Hospital for Children, Bristol, UK
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Cook TM, Harrop-Griffiths AW, Whitaker DK, McNarry AF, Patel A, McGuire B. The 'No Trace=Wrong Place' campaign. Br J Anaesth 2019; 122:e68-e69. [PMID: 30857613 DOI: 10.1016/j.bja.2019.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 12/20/2022] Open
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55
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Affiliation(s)
- T M Cook
- Royal United Hospital Bath NHS Foundation Trust, Bath, UK
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56
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The Difficult Airway Trolley: A Narrative Review and Practical Guide. Anesthesiol Res Pract 2019; 2019:6780254. [PMID: 30833967 PMCID: PMC6369510 DOI: 10.1155/2019/6780254] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/06/2018] [Accepted: 01/01/2019] [Indexed: 01/14/2023] Open
Abstract
Death and severe morbidity attributable to anesthesia are commonly associated with failed difficult airway management. When an airway emergency develops, immediate access to difficult airway equipment is critical for implementation of rescue strategies. Previously, national expert consensus guidelines have provided only limited guidance for the design and setup of a difficult airway trolley. The overarching aim of the current work was to create a dedicated difficult airway trolley (for patients>12 years old) for use in anesthesia theatres, intensive care units, and emergency departments. A systematic literature search was performed, using the PubMed, Embase, and Google Scholar search engines. Based on evidence presented in 11 national or international guidelines, and peer-reviewed journals, we present and outline a difficult airway trolley organized to accommodate sequential progression through a four-step difficult airway algorithm. The contents of the top four drawers correspond to specific steps in the airway algorithm (A = intubation, B = oxygenation via a supraglottic airway device, C = facemask ventilation, and D = emergency invasive airway access). Additionally, specialized airway equipment may be included in the fifth drawer of the proposed difficult airway trolley, thus enabling widespread use. A logically designed, guideline-based difficult airway trolley is a vital resource for any clinician involved in airway management and may aid the adherence to difficult airway algorithms during evolving airway emergencies. Future research examining the availability of rescue airway devices in various clinical settings, and simulation studies comparing different types of difficult airway trolleys, are encouraged.
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57
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Chrimes N, Bradley WPL, Gatward JJ, Weatherall AD. Human factors and the ‘next generation’ airway trolley. Anaesthesia 2018; 74:427-433. [DOI: 10.1111/anae.14543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2018] [Indexed: 01/09/2023]
Affiliation(s)
- N. Chrimes
- Department of Anaesthesia Monash Medical Centre Melbourne Vic. Australia
| | - W. P. L. Bradley
- Department of Anaesthesia and Peri‐operative Medicine The Alfred Melbourne Vic. Australia
- Monash University Melbourne Vic. Australia
| | - J. J. Gatward
- Intensive Care Unit Royal North Shore Hospital St Leonards NSW Australia
- Sydney Medical School University of Sydney Camperdown NSW Australia
| | - A. D. Weatherall
- Department of Anaesthesia The Children's Hospital at Westmead Westmead NSW Australia
- Division of Child and Adolescent Health The University of Sydney Camperdown NSW Australia
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58
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59
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Doherty C, Neal R, English C, Cooke J, Atkinson D, Bates L, Moore J, Monks S, Bowler M, Bruce IA, Bateman N, Wyatt M, Russell J, Perkins R, McGrath BA. Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies. Anaesthesia 2018; 73:1400-1417. [PMID: 30062783 DOI: 10.1111/anae.14307] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 01/09/2023]
Abstract
Temporary and permanent tracheostomies are required in children to manage actual or anticipated long-term ventilatory support, to aid secretion management or to manage fixed upper airway obstruction. Tracheostomies may be required from the first few moments of life, with the majority performed in children < 4 years of age. Although similarities with adult tracheostomies are apparent, there are key differences when managing the routine and emergency care of children with tracheostomies. The National Tracheostomy Safety Project identified the need for structured guidelines to aid multidisciplinary clinical decision making during paediatric tracheostomy emergencies. These guidelines describe the development of a bespoke emergency management algorithm and supporting resources. Our aim is to reduce the frequency, nature and severity of paediatric tracheostomy emergencies through preparation and education of staff, parents, carers and patients.
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Affiliation(s)
- C Doherty
- Department of Paediatric Anaesthesia, Manchester University NHS Foundation Trust, Manchester, UK
| | - R Neal
- Paediatric Intensive Care Medicine, Paediatrics, Birmingham Children's Hospital, Birmingham, UK
| | - C English
- Department of Paediatric ENT, Manchester University NHS Foundation Trust, Manchester, UK
| | - J Cooke
- Department of Paediatric Otolaryngology, Great Ormond Street Hospital, London, UK
| | - D Atkinson
- Department of Anaesthesia and Intensive Care Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - L Bates
- Department of Anaesthesia and Intensive Care Medicine, Royal Bolton Hospital, Bolton, UK
| | - J Moore
- Department of Anaesthesia and Intensive Care Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - S Monks
- Department of Anaesthesia, East Lancashire Hospitals NHS Trust, Burnley, UK
| | - M Bowler
- Department of Paediatric Anaesthesia, Manchester University NHS Foundation Trust, Manchester, UK
| | - I A Bruce
- Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - N Bateman
- Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester, UK
| | - M Wyatt
- Department of Paediatric Otolaryngology, Great Ormond Street Hospital, London, UK
| | - J Russell
- Department of Paediatric ENT, Our Lady's Children's Hospital, Dublin, Ireland
| | - R Perkins
- Department of Paediatric Anaesthesia, Manchester University NHS Foundation Trust, Manchester, UK
| | - B A McGrath
- Department of Anaesthesia and Intensive Care Medicine, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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60
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Foy KE, Mew E, Cook TM, Bower J, Knight P, Dean S, Herneman K, Marden B, Kelly FE. Paediatric intensive care and neonatal intensive care airway management in the United Kingdom: the PIC-NIC survey. Anaesthesia 2018; 73:1337-1344. [PMID: 30112809 DOI: 10.1111/anae.14359] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2018] [Indexed: 12/18/2022]
Abstract
In 2011, the Fourth National Audit Project (NAP4) reported high rates of airway complications in adult intensive care units (ICUs), including death or brain injury, and recommended preparation for airway difficulty, immediately available difficult airway equipment and routine use of waveform capnography monitoring. More than 80% of UK adult intensive care units have subsequently changed practice. Undetected oesophageal intubation has recently been listed as a 'Never Event' in UK practice, with capnography mandated. We investigated whether the NAP4 recommendations have been embedded into paediatric and neonatal intensive care practice by conducting a telephone survey of senior medical or nursing staff in UK paediatric intensive care units (PICUs) and neonatal intensive care units (NICUs). Response rates were 100% for paediatric intensive care units and 90% for neonatal intensive care units. A difficult airway policy existed in 67% of paediatric intensive care units and in 40% of neonatal intensive care units; a pre-intubation checklist was used in 70% of paediatric intensive care units and in 42% of neonatal intensive care units; a difficult intubation trolley was present in 96% of paediatric intensive care units and in 50% of neonatal intensive care units; a videolaryngoscope was available in 55% of paediatric intensive care units and in 29% of neonatal intensive care units; capnography was 'available' in 100% of paediatric intensive care units and in 46% of neonatal intensive care units, and 'always available' in 100% of paediatric intensive care units and in 18% of neonatal intensive care units. Death or serious harm occurring secondary to complications of airway management in the last 5 years was reported in 19% of paediatric intensive care units and in 26% of neonatal intensive care units. We conclude that major gaps in optimal airway management provision exist in UK paediatric intensive care units and especially in UK neonatal intensive care units. Wider implementation of waveform capnography is necessary to ensure compliance with the new 'Never Event' and has the potential to improve airway management.
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Affiliation(s)
- K E Foy
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK
| | - E Mew
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK
| | - T M Cook
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK
| | - J Bower
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK
| | - P Knight
- Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, UK
| | - S Dean
- Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, UK
| | - K Herneman
- Department of Anaesthesia, Southmead Hospital, Bristol, UK
| | - B Marden
- Neonatal Intensive Care Unit, Royal United Hospital, Bath, UK
| | - F E Kelly
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK
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61
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Mir F, McNarry A, Asai T. Role of the Difficult Airway Society in improving airway management. Br J Anaesth 2018; 121:12-15. [DOI: 10.1016/j.bja.2018.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/03/2018] [Accepted: 04/05/2018] [Indexed: 12/17/2022] Open
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62
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Harper N, Cook T, Garcez T, Lucas D, Thomas M, Kemp H, Kong KL, Marinho S, Karanam S, Ferguson K, Hitchman J, Torevell H, Warner A, Egner W, Nasser S, McGuire N, Bellamy M, Floss K, Farmer L, Farooque S. Anaesthesia, surgery, and life-threatening allergic reactions: management and outcomes in the 6th National Audit Project (NAP6). Br J Anaesth 2018; 121:172-188. [DOI: 10.1016/j.bja.2018.04.015] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/08/2018] [Accepted: 04/16/2018] [Indexed: 12/20/2022] Open
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63
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McCarthy S, Cooper RM. A primer on the ethics of teaching and learning in airway management. Anaesthesia 2018; 73:940-945. [DOI: 10.1111/anae.14313] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | - R. M. Cooper
- Department of Anaesthesia; University of Toronto; Toronto Canada
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64
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Arulkumaran N, McLaren CS, Arulkumaran K, Philips BJ, Cecconi M. An analysis of emergency tracheal intubations in critically ill patients by critical care trainees. J Intensive Care Soc 2018; 19:180-187. [PMID: 30159008 DOI: 10.1177/1751143717749686] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction We evaluated intensive care medicine trainees' practice of emergency intubations in the United Kingdom. Methods Retrospective analysis of 881 in-hospital emergency intubations over a three-year period using an online trainee logbook. Results Emergency intubations out-of-hours were less frequent than in-hours, both on weekdays and weekends. Complications occurred in 9% of cases, with no association with time of day/day of week (p = 0.860). Complications were associated with higher Cormack and Lehane grades (p=0.004) and number of intubation attempts (p < 0.001), but not American Society of Anesthesiologist grade. Capnography usage was ≥99% in all locations except in wards (85%; p = 0.001). Ward patients were the oldest (p < 0.001), had higher American Society of Anesthesiologist grades (p < 0.001) and lowest Glasgow Coma Scale (p < 0.001). Conclusions Complications of intubations are associated with higher Cormack and Lehane grades and number of attempts, but not time of day/day of week. The uptake of capnography is reassuring, although there is scope for improvement on the ward.
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Affiliation(s)
- Nishkantha Arulkumaran
- General Intensive Care Unit, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Charles S McLaren
- Intensive Care Medicine, Hillingdon Hospital Foundation Trust, London, UK
| | | | - Barbara J Philips
- General Intensive Care Unit, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Maurizio Cecconi
- General Intensive Care Unit, St George's University Hospitals NHS Foundation Trust, London, UK
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65
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Cook TM. Strategies for the prevention of airway complications - a narrative review. Anaesthesia 2017; 73:93-111. [DOI: 10.1111/anae.14123] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 12/17/2022]
Affiliation(s)
- T. M. Cook
- Anaesthesia and Intensive Care Medicine; Royal United Hospital; Bath UK
- School of Clinical Sciences; Bristol University; Bristol UK
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66
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Higgs A, McGrath BA, Goddard C, Rangasami J, Suntharalingam G, Gale R, Cook TM. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth 2017; 120:323-352. [PMID: 29406182 DOI: 10.1016/j.bja.2017.10.021] [Citation(s) in RCA: 458] [Impact Index Per Article: 65.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/23/2017] [Accepted: 10/25/2017] [Indexed: 12/17/2022] Open
Abstract
These guidelines describe a comprehensive strategy to optimize oxygenation, airway management, and tracheal intubation in critically ill patients, in all hospital locations. They are a direct response to the 4th National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society, which highlighted deficient management of these extremely vulnerable patients leading to major complications and avoidable deaths. They are founded on robust evidence where available, supplemented by expert consensus opinion where it is not. These guidelines recognize that improved outcomes of emergency airway management require closer attention to human factors, rather than simply introduction of new devices or improved technical proficiency. They stress the role of the airway team, a shared mental model, planning, and communication throughout airway management. The primacy of oxygenation including pre- and peroxygenation is emphasized. A modified rapid sequence approach is recommended. Optimal management is presented in an algorithm that combines Plans B and C, incorporating elements of the Vortex approach. To avoid delays and task fixation, the importance of limiting procedural attempts, promptly recognizing failure, and transitioning to the next algorithm step are emphasized. The guidelines recommend early use of a videolaryngoscope, with a screen visible to all, and second generation supraglottic airways for airway rescue. Recommendations for emergency front of neck airway are for a scalpel-bougie-tube technique while acknowledging the value of other techniques performed by trained experts. As most critical care airway catastrophes occur after intubation, from dislodged or blocked tubes, essential methods to avoid these complications are also emphasized.
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Affiliation(s)
- A Higgs
- Anaesthesia and Intensive Care Medicine, Warrington and Halton Hospitals NHS Foundation Trust, Cheshire, UK(8).
| | - B A McGrath
- Anaesthesia and Intensive Care Medicine, University Hospital South Manchester, Manchester, UK(9)
| | - C Goddard
- Anaesthesia & Intensive Care Medicine, Southport and Ormskirk Hospitals NHS Trust, Southport, UK(8)
| | - J Rangasami
- Anaesthesia & Intensive Care Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK(8)
| | - G Suntharalingam
- Intensive Care Medicine and Anaesthesia, London North West Healthcare NHS Trust, London, UK(10)
| | - R Gale
- Anaesthesia & Intensive Care Medicine, Countess of Chester Hospital NHS Foundation Trust, Chester, UK(11)
| | - T M Cook
- Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK(12)
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67
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Asai T. Airway management inside and outside operating rooms-circumstances are quite different. Br J Anaesth 2017; 120:207-209. [PMID: 29406169 DOI: 10.1016/j.bja.2017.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 10/27/2017] [Accepted: 10/27/2017] [Indexed: 12/20/2022] Open
Affiliation(s)
- T Asai
- Department of Anesthesiology, Dokkyo Medical University Saitama Medical Centre, Koshigaya, Japan.
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68
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Greenland K, Bradley W, Chapman G, Goulding G, Irwin M. Emergency front-of-neck access: scalpel or cannula'and the parable of Buridan's ass †. Br J Anaesth 2017; 118:811-814. [DOI: 10.1093/bja/aex101] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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69
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Long E, Cincotta D, Grindlay J, Pellicano A, Clifford M, Sabato S. Implementation of NAP4 emergency airway management recommendations in a quaternary-level pediatric hospital. Paediatr Anaesth 2017; 27:451-460. [PMID: 28244630 DOI: 10.1111/pan.13128] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2017] [Indexed: 12/22/2022]
Abstract
Emergency airway management, particularly outside of the operating room, is associated with a high incidence of life-threatening adverse events. Based on the recommendations of the 4th National Audit Project, we aimed to develop hospital-wide systems changes to improve the safety of emergency airway management. We describe a framework for governance in the form of a hospital airway special interest group. We describe the development and implementation of the following systems changes: 1. A local intubation algorithm modified from the Difficult Airway Society's plan A-B-C-D approach, including clear pathways for airway escalation, and emphasizing the concepts of resuscitation prior to intubation, planning for failure, and avoidance of fixation error. 2. Simplified and standardized airway equipment located in identical airway carts in all critical care areas. 3. A preintubation checklist and equipment template to standardize preparation for airway management. 4. Availability of continuous waveform endtidal capnography in all critical care areas for confirmation of correct endotracheal tube placement. 5. Multidisciplinary team training to address the technical and nontechnical aspects of nonoperating room intubation. In addition, we describe methodology for ongoing monitoring of performance through a quality assurance framework. In conclusion, changes in the process of emergency airway management at a hospital level are feasible through collaboration. Their impact on patient-based outcomes requires further study.
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Affiliation(s)
- Elliot Long
- Department of Emergency Medicine, The Royal Children's Hospital, Parkville, Vic, Australia.,Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Vic, Australia
| | - Domenic Cincotta
- Department of Emergency Medicine, The Royal Children's Hospital, Parkville, Vic, Australia.,Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Vic, Australia
| | - Joanne Grindlay
- Department of Emergency Medicine, The Royal Children's Hospital, Parkville, Vic, Australia.,Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Vic, Australia
| | - Anastasia Pellicano
- Department of Neonatal Medicine, The Royal Children's Hospital, Parkville, Vic, Australia
| | - Michael Clifford
- Murdoch Children's Research Institute, Parkville, Vic, Australia.,Paediatric Intensive Care Unit, The Royal Children's Hospital, Parkville, Vic, Australia.,Department of Anaesthesia and Pain Management, The Royal Children's Hospital, Parkville, Vic, Australia
| | - Stefan Sabato
- Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Anaesthesia and Pain Management, The Royal Children's Hospital, Parkville, Vic, Australia
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70
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Moppett I, Moonesinghe S, Grocott M. National audits in the UK: fancy acronyms or real patient benefit? Br J Anaesth 2017; 118:479-482. [DOI: 10.1093/bja/aew437] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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71
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Cook TM. Measuring the clinical impact of National Audit Projects. Anaesthesia 2016; 71:1374-1376. [DOI: 10.1111/anae.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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